The Stages Of Body Grief

I work with clients for a variety of reasons. Eating disorder recovery, quitting dieting, hypothalamic amenorrhea (the fancy name for not getting a period), exercise compulsion, and poor bone health, to name a few. 

And what’s interesting is that, irrespective of the main reason someone wants to work with me, body image is always a big part of it.

Body Image 

Our body image is made up of many parts. It includes:

• Visual – how we see our physical body. This is never exactly as the body is, but it is our perception
• Emotional – the meaning and beliefs we assign to our body
• Kinaesthetic – our perception and connection to the movement and sensations of our body
• Historical – the lifetime of experiences our body has endured
• Behavioural – the actions and behaviours that we take based on our body image, that then further reinforce our thoughts, feelings and beliefs

Much of what we work on when focusing on body image is coming to terms with and accepting one’s body for how it is rather than how we wish it would be.

A couple of weeks ago I interviewed Bri Campos for the podcast. Bri is a body image coach and educator and she uses a framework of body grief when helping both clients and practitioners to understand body image. 

The framework that Bri has devised for body grief is incredible and is something I now regularly use with clients. So, what I want to do with today’s post is to explain the stages of body grief.

(Note: Bri and I go into this topic in much more detail in our podcast conversation, so if you haven’t listened to the episode yet, you can do so here. Bri also has a Body Grief Guide which I highly suggest checking out here and many of the ideas in this article were informed by our conversation and her guide.)

What Is Body Grief?

Grief is defined as sorrow caused by loss that is associated with distress. While our own impending death or the death of a loved one is often the thing we instantly think of when we think about grief, we can experience grief for many reasons outside of this.

Some of these reasons are: the loss of a job or income, major rejection (like social rejection and family estrangement), the end of a relationship or divorce, the onset of a disease or an infertility diagnosis, addiction of all kinds, and incarceration.

We can also have grief for our body.

Bri defines body grief as “the distress caused by the perceived loss accompanied with the body changes, often changes out of our control.”

There are many reasons or ways that our body can change:

• Quitting dieting
• Eating disorder recovery
• Illness (both acute and chronic)
• Puberty
• Ageing, especially around menopause
• Loss of mobility
• Surgery
• Trauma 

These changes can affect not just the appearance of the body, but also its functioning and one’s ability to do certain tasks and hobbies. And often, it can affect all of these areas together. 

The Five Stages Of Body Grief

In 1969 psychiatrist Elisabeth Kubler-Ross released her groundbreaking book On Death and Dying. In the book, she outlined five stages of grief: denial, anger, bargaining, depression, and acceptance.

Let’s look at these from the perspective of body grief.

Denial 

Denial is the refusal to accept how our body is. As Bri describes “this stage is often used to minimise the pain as we attempt to understand the current reality.”

What this looks like is making choices in an attempt to change this reality. So, this could be not eating despite feeling hungry or exercising despite feeling pain or becoming dizzy.

Or it could be denying the severity of an eating disorder or that you are really “sick enough” to need help. Although, as I talk about in this podcast, this can be less about denial and more about anosognosia.

On the surface, denial can often appear as a positive trait. You are taking charge. You are getting “back on track.” But the reality is, this denial is leading to choices and behaviours that aren’t in support of true health and happiness. And this then leads onto the next stage…

Anger

Anger arises as you notice the difference between where things are and where you want them to be. As Bri describes “[anger] is used to mitigate this new pain through “control.” Anger is the first response to this new feeling of loss.”

Rather than anger at diet culture, our fatphobic society or weight-biased medical care, this anger is turned inwards. It leads to negative self-talk and speaking to ourselves in ways we would never speak to someone else.

This anger can be triggered by others: comments from friends, family, doctors, or online trolls. But still, this anger tends to be turned inwards rather than towards the people making the comments.

For those with an eating disorder, there can be anger at the inability to be able to keep up certain behaviours or how exhausting it feels to keep the status quo. The anger is at a body that should make this easier than it is or why won’t it just comply with how you want it to be.  

Bargaining

The next stage is bargaining. This is when the reality of the situation can be seen, but one is still trying and hoping to figure a way out. As Bri describes “This stage is used to avoid feeling new pain from the anticipated loss.”

This can look like starting a new diet, with the hope that this time it will be different. Or it could mean avoiding or postponing holidays, doctor’s visits or doing certain activities, with the intention of doing them later when the body has changed.   

For someone with an eating disorder, bargaining could mean starting to entertain recovery but doing so with lots of caveats.

I’ll eat more, but it can’t be more than X number of calories

I’ll eat more, but my weight has to stay the same otherwise I’m stopping

I’ll eat more, but I’m going to increase my exercise to compensate

I’m going to do reverse dieting, so I can heal my eating disorder but I won’t gain any unnecessary weight

This bargaining stage can feel a lot like the denial stage, with the difference being that there is an increased level of awareness at the bargaining stage, even though acceptance is still missing.

And as I mentioned when I spoke with Bri, it often feels like people get stuck in a loop of these first three stages, never moving forward from here.

Depression

The next stage of grief is depression. This is where the reality of the situation hits home. What you thought of as temporary or something that could be changed is realised to be a permanent situation. This can lead to feelings of sadness, hopelessness and withdrawal. 

There is no way to sugarcoat it, this stage sucks. It can be a crushing blow to finally realise all that hard work and all those dreams of something different aren’t going to happen. And if this is something you’ve been chasing for decades or for as long as you can remember, this takes time to get your head around.

For someone with an eating disorder, this can be the point of realising:

• That you need to do recovery for real
• That your body is going to change in ways you don’t want it to
• That you’ll need to eat foods that you feel uncomfortable with
• That keeping on as you have been is unsustainable
• And that you’re going to lose a coping mechanism that has served you for a long time

None of these feel like positive realisations. 

But as much as this stage sucks, it is also the birthplace of a better life. Depression is the cocoon stage, while acceptance is the emergence of the butterfly.

Acceptance

Acceptance is the five stage of grief and is where you are able to see the reality of the situation and you are ok with it. It doesn’t mean liking the situation, but rather you are able to manage your expectations.

So rather than trying to fight the situation, you instead look at how you speak to yourself. You explore your beliefs and how they are helping or harming you. You learn to be self-compassionate. 

For someone with an eating disorder, this stage is about doing recovery, despite the challenges and messiness that it brings up.

Three Extra Stages Of Grief

Interestingly, Kubler-Ross later expanded her five-stage model to a seven-stage model, adding two extra stages. The full seven stages are: shock, denial, anger, bargaining, depression, testing and acceptance

Shock

Shock is the first additional stage and it is the first of the seven stages. Shock describes the initial response of emotional paralysis or numbness following the bad news.

In our conversation, Bri talked about the passing of her brother and how initially she said she was fine and spent time in this state of shock.

In the realm of body grief shock could be the result of:

• Doing a diet that you believe was going to cure your autoimmune disease, only to find it doesn’t
• Having weight loss surgery and realising it hasn’t and isn’t going to change your weight in the way that you hoped
• Receiving a diagnosis of cancer, early onset Alzheimer’s or being told you need a hysterectomy when you were anticipating getting pregnant 

Testing

Testing is the other additional stage and is a bridge between depression and acceptance. During this stage, you start to experiment with ways to manage and cope with the loss. It could be thought about as “acceptance-curious” as you begin to dabble with new ways of thinking and behaving. 

In the area of body grief this could look like:

• Starting to listen to podcasts or read books connected to Health At Every Size, Intuitive Eating and starting to think about taking care of yourself in a weight-neutral way
• Starting to follow fat activists or fashion bloggers activists on Instagram
• Reaching out to a therapist or dietician to explore the idea of getting support for your eating disorder recovery

Finding Meaning

David Kessler is an author, public speaker, and death and grieving expert. He also co-authored two books with Kubler-Ross.

In 2019 he released the book Finding Meaning: The Sixth Stage of Grief. This was a book that was based on his work with Kubler-Ross, being a grief expert but also the sudden death of his 21-year-old son.

Kessler believes that finding meaning is another stage in the grief process. 

Bri talked about how she has found meaning in helping others with body image struggles. That being in community with others, speaking up for others and using this grief model has given her a huge sense of meaning and purpose. 

For your own body grief meaning could look like:

• Realising that you don’t want your kids to suffer in the way that you have and have this support you in changing your relationship with food and your body
• Discovering how many people are harmed because of biased medical care and making it your mission to change this.
• Realising that the way that kids are taught about food and weight at school is incredibly damaging and creating a business to tackle this

As you can see from the examples above, meaning can be something that is big and focuses on changing the lives of many people. But equally, it doesn’t have to be and you can find meaning by supporting your own family.

Grief Is Varied, Not Linear

While it can be easy to think about the stages of grief as linear, this is definitely not the case. It is completely normal to move in and out of these different stages. One day you feel depressed about the situation, the next you are back in bargaining mode, the next you’re a ball of rage.  And this can go on for months or years. 

And even when you have supposedly reached a place of acceptance, discomfort and disappointment can still rise up. Because acceptance is an on-going practice, rather than a destination. And grief is messy, non-linear and anything but stable and neat. 

Even after years of working on body grief, certain events can be triggering and leave you reeling. The difference though between this current trigger and at the start of the body grief journey is that you now have the tools to better cope with this situation.

You know how to:

• “Sit in the suck” as Bri calls it.
• To treat yourself with kindness and compassion
• To reach out for the support of someone who knows how to be with you in these moments
• To notice your thoughts and judgements without becoming swept away with them
• To cope without resorting to dieting, compulsive exercise or other ways that attempt to change your body

This can still be a messy experience and there may be situations like this that occur indefinitely. But as time goes on and as you spend more of your life with a mindset of acceptance, you become better at moving through these experiences.

Wanting Help?

As I mentioned at the start, body image is something that is a part of the work I do we every client. And despite how you currently feel, I truly believe that you can improve from where your body image is right now.

To quote Bri: “I believed the lie that the size of my body was the thing keeping me from living a full life. But what I discovered was that it was not my body, but my beliefs about my body that were keeping me from living a full life.”

If you’d like to change your beliefs and the actions that you take based on these beliefs, I’d love to help. Bri does too.

I’m a leading expert and advocate for full recovery. I’ve been working with clients for over 15 years and understand what needs to happen to recover.

I truly believe that you can reach a place where the eating disorder is a thing of the past and I want to help you get there. If you want to fully recover and drastically increase the quality of your life, I’d love to help.

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